Perceived and actual control in patients with severe asthma: results from a global online survey

Abstract

Introduction: Asthma control assessment is important in patients (pts) with severe asthma, where OCS use, exacerbations and mortality risk are high. We compared the actual (as per GINA) and perceived control (PC) in pts with severe asthma. Methods: Data were collected in 1333 pts [adult (>18yrs) and caregivers of minor pts (6–17yrs)] with severe persistent asthma from 9 countries via a global 20-minute online survey conducted by GfK for Novartis during 2016. Results: A discrepancy was seen between real-life asthma control as per GINA guidelines (6%) and PC (42%). A decision tree analysis showed that higher WHO-5 score (Figure 1a) was a predictor of positive subjective perception of asthma control by pts with uncontrolled asthma based on GINA (disconnect between objective and subjective disease control; Figure 1b ). More days on oral corticosteroids and bad sleep quality were predictors of negative objective asthma control (based on GINA) for pts who subjectively perceive their asthma as well controlled. These analysis fall short in explaining what drives the discrepancy between objective and subjective control of asthma in general due to small sample sizes in particular subgroups. Conclusion: A discrepancy exists in ‘asthma control’ as per GINA and as perceived by patients. We identified the predictors of perceived and actual control (GINA); however, the reason for disconnect between these measures still remains unknown.